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Posted Tuesday, August 28, 2012

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Author
Topic: Insertive + lymph node (Read 3751 times)

As someone with health anxiety, I have probably read the entirety of your archives over the last few years. Unfortunately, I am writing with an actual high-risk exposure, unprotected insertive anal with a promiscuous much younger guy who claimed to be negative and was adamant about knowing my status but clearly practiced a range of dubious protective strategies including serosorting and not accepting full ejaculation in the anus.

I made the poor choice of abandoning the condom when it inhibited my erection. I then made a second poor choice by foregoing pep based on the advice of a counselor who thought the odds were minuscule for a one-time unprotected top.

As I mentioned I am a rather severe hypochondriac and attributed a range of probably random symptoms to this event in the month that followed. However, my latest discovery strikes me as more dire.

On day 36 post-encounter, I accidentally came across an enlarged, shotty lymph node below my jaw on the left side. It is moveable and can be rolled with two fingers. Additionally, I am aware of a congested sensation in the area when turning my head or sitting in different positions. While correlation does not equal causality, it seems that hiv and lymph swellings are somewhat ubiquitously paired and I have never noticed anything like this in my own body before.

I also know that this site doesn't really address symptoms but am still compelled to seek feedback while I pass the time until I can test. Incidentally, I am living abroad without any real health coverage and am planning to travel to a nearby larger city to test anonymously, since I don't know what impact a diagnosis would have on my unique professional situation.

One week following my unearthing of the shotty node, my throat swelled up and has today resolved leaving me with a seemingly typical cold.

The worst part of all of this for me is that I have likely been infected at a time when pep and chemo-profilaxis (prep) are making hiv more or less avoidable for anyone who doesn't want it.

I ask not to be lectured as I live under my own judgement already. That said I welcome, from experts, both reassuring responses and those that share my skepticism that this is just a mere coincidence.

The only way to know if you are infected is to test , your symptoms are not HIV specific so there is really nothing more to say about that .

You can test 6 weeks post exposure and again at 3 months to confirm the results . You probably need to get checked out for all std's since they are much easier to contract than HIV and linger without symptoms .

Since the discovery of the enlarged lymph node on week 5, I've been in a living hell with symptoms not in any way coming all at once and disappearing together but diversely accumulating, some likely due to anxiety but others that would be difficult to manufacture. A few days ago, my eyes, which had been feeling odd in their sockets, began to burn acutely. Since then I have not been producing tears (after crying profusely for weeks) and am suffering persistent, sometimes painful dryness also involving the sinuses and numb facial sensations. It seems the tear-duct issue is a common chronic problem that can be triggered by hiv, other viruses and auto-immune disorders.

Two days ago, I was stunned when I tested negative on an insti rapid test at 8 weeks (58 days) post-exposure as I was fully expecting a positive result. The test result brought considerable relief but only until I realized all of my symptoms remained and that the result was likely false or my antibodies still not detectable or that maybe I'm hosting a different virus (or co-infection that is rumored to extend the time to antibodies).

Why am I telling you this? Maybe to keep myself from another desperate call to my therapist or exhausted friends. I will finally seek medical attention, something I've been deferring due to logistics of my situation and likely at great cost.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Thank you for your response and tough reassurance. Although a strong believer in coincidence, it's hard for me to imagine that my next test will not be positive given the still-enlarged lymph node and this completely sudden & uncomfortable tear-gland shutdown amongst other associated but non-specific physical clues. It may very well all be due to an auto-immune disorder or cancer but the timing in relation to my risk is conspicuous. I can't help but think it has just taken me a bit longer to detectably seroconvert or that I received a false negative (I came across a study were INSTI missed 3 of 15 early infections). I do still hope to test negative but am suspiciously already inhabiting some sort of disruptive systemic process.

Anyway, there goes my last free post. If I am negative, I'll purchase a subscription and give an update as I do not wish to fuel anyone else's panic around the generally well-established stability of 8 week test results.

Thanks for the further encouragement. I've just had a second negative INSTI at 11.5 weeks (80 days). I'd love to accept this as basically conclusive but I still have (among other lingering symptoms) an enlarged lymph node in my neck that is mobile and feels like a small to medium-sized bean (fluctuates a bit). After the 8 week test, I saw a doctor who told me the swelling was bilateral, pointing out a much smaller twin node on the other side. I am ready to look into other causes but will probably also want to have an actual blood draw (or at least a different kind of rapid) in case the 60 second finger-prick is not detecting an infection. The tests have been at a peer-based clinic so they are not health professionals (though the project is overseen by a board of medical advisors). Should I let myself feel any more relieved than I do? It was incredibly soothing to be told not to worry (or at least to worry about other things) but I'm also confused and still not sure how to resolve this with what (& when) my body is presenting.

Two weeks ago, I had a third negative INSTI at 16 weeks, this time at a private clinic, where I was told it's 99.9% accurate after 90 days. But each time I eliminate another cause for the tell-tale swollen nodes in my neck, I return to hiv, the original obvious suspect.

I don't dismiss the results I've been given, but they haven't given me closure since multiple depressing signs of a systemic problem still persist. Is it really possible that I'm not infected? Instinctively, I don't believe it but I agree to be reasonable. I will be seeing a new doctor and I will also do a lab-based elisa. I've had negative tests for syphilis and ebv.

While I know that there are other less self-evident possibilities, I'm worried about false negatives, accuracy of rapid tests with early-ish infection, slow seroconversion caused by coinfections and all kinds of speculative outliers, like the fact that INSTI has antigen for gp41 and not also gp120. For now, my (Am I) question remains open, at least for me, but maybe something will come to light soon. Over time, it becomes a bit less about a particular fear and more about the troubling uncertainty of an undiagnosed condition.

http://www.cdc.gov/globalaids/Resources/pmtct-care/docs/TM/Module_6TM.pdfPage 11 #4 In an adult, a positive HIV antibody test result means that the person is infected, a person with a negative or inconclusive result may be in the “window for 4 to 6 weeks but occasionally up to 3 months after HIV exposure. Persons at high risk who initially test negative should be retested 3 months after exposure to confirm results

If you're touching your lymph glands all the time to see if they're swollen, you could actually be causing them to swell. Keep your hands off them!

Lymph glands will swell for all sorts of reasons, not just hiv. Keep working with your doctor to find out what is actually going on. You believe the tests that ruled out syphilis and EBV, now it's time to believe the tests that ruled out hiv.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

First off, thank you sincerely for your responses. They have given me some hope to counteract my skepticism.

I now have a significant clue in the mystery of my condition. I've tested positive for cmv with both early and late antibodies, indicating recent or active/waning infection. This can explain my symptoms in-and-of itself if it is a true primary infection.

But my immediate worry is that this points to coinfection with - or reactivation by - hiv.

There are many reasons for this: cmv infrequently creates symptoms in immunocompetent hosts, most people are exposed in infancy, and it is so woven into the hiv narrative that it was once considered by some to be causative of aids and is still both a possible cofactor and a definite opportunistic infection.

Keeping in mind that I've only had insti rapid tests (out to 16 weeks) and no 4th generation or RNA lab-work, what is the true clinical picture?

Can a gay man - over 35 - in a high-risk exposure - contract cmv but not hiv? It's clearly possible but is it likely?

Most people have been exposed to CMV during the course of their lives. So yes, it's extremely likely.

Whatever is going on, you have conclusively and reliably tested hiv NEGATIVE.

YOU DO NOT HAVE HIV!!!

If you read the Welcome Thread before posting like you're supposed to, you will have read the following posting guideline:

Quote

Anyone who continues to post excessively, questioning a conclusive negative result or no-risk situation, will be subject to a four week Time Out (a temporary ban from the Forums). If you continue to post excessively after one Time Out, you may be given a second Time Out which will last eight weeks. There is no third Time Out - it is a permanent ban. The purpose of a Time Out is to encourage you to seek the face-to-face help we cannot provide on this forum.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Thanks. Just to clarify: I'm talking about active / recent infection (igm & igg). I understand I may be more skeptical of FDA-approved rapid tests, but think it's important not to shut down dialogue/curiosity?

Thanks. Just to clarify: I'm talking about active / recent infection (igm & igg). I understand I may be more skeptical of FDA-approved rapid tests, but think it's important not to shut down dialogue/curiosity?

We certainly do not shut down dialogue on this site. But this forum is not a discussion forum. That is why we have the three free post maximum and the paid subscriptions, to discourage excessive posting when we have exhausted our science-based risk assessment.

As for CMV, it is a very very common virus that the at least 60% of the population is exposed to, and develop antibodies for, by the time they reach adulthood.

If you do not trust the efficacy of OTC rapid tests for HIV (which are identical to the tests used in many clinics) then by all means see a doctor or clinic and get a blood test done for peace of mind. If you are skeptical of even blood tests, then I am at a loss as to what you should to to ease your fear of infection, except to suggest counseling to deal with it. Cognitive Behavioral Therapy has shown great promise in overcoming irrational fear of HIV and other pathogens.

In any case, you do not have HIV.

Logged

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

Yes, thank you. I'm very appreciative of your work. I guess I'm just leaving a record for myself and others. I certainly will not post again if nothing changes in my tests but I think it's worth sharing my experience. I'm frightened but also know that if I have a positive test, I'm in very good company!

It's strange to have swollen lymph nodes in the neck, a hallmark of hiv, for months - after a real risk - and to then be told it's cmv, a disease mainly suffered by the immunocompromised. I don't claim to know what's happening. I also do have a history of hypochondria, but hypochondriacs also do get sick. And then there is data out there about delayed seroconversion and limitations of rapid tests that look for a single antibody.

I will definitely avoid excessive posting! I'm just trying to make sense of my experience and I am aware of being a bit paranoid and skeptical by nature but I think that's important.